Paediatrics Unit, Universitat Rovira i Virgili, IISPV, Reus, Spain.
J Pediatr Gastroenterol Nutr. 2013 Mar;56(3):320-7. doi: 10.1097/MPG.0b013e3182779a60.
The estimation of dietary intake remains a challenge in human nutritional studies. In infants, the use of food diaries (FDs) is a suitable method already validated; however, this method is not exempt from error. In formula-fed infants, dilution of powdered formulas may produce errors. Our aim was to develop and validate standard operating procedures (SOPs) for the assessment of dietary intake in formula-fed infants, attending potential sources of error.
We analysed sources of error in a random subsample of 3-day FDs from 100 infants enrolled in the European Childhood Obesity Project. Calculations to estimate intakes were standardised and included in a software tool (SOPsystem). An evaluation of a simulated FD was performed by 9 trained nutritionists and 23 nutrition students (n=225 and n=575 bottle evaluations, respectively) to compare the results obtained when using or not the SOPsystem. Correct answers (%), coefficients of variation, and the time spent (minutes) to assess the simulated FD were analysed.
Overall, 60% of the FDs contained reports of incorrect volumes, and 37% reported incorrect formula dilutions. When the SOPsystem was used, correct answers in the simulated FD were more frequent (P<0.001) and the mean coefficient of variation and the time spent were lower (P<0.005 and P<0.01, respectively).
The development and implementation of SOPs with a software tool that identifies specific sources of error in record-keeping achieved a harmonised and improved process for assessing dietary intakes in formula-fed infants, minimising errors in calculations and reducing the work time invested.
在人类营养研究中，膳食摄入量的评估仍然具有挑战性。在婴儿中，使用食物日记（FD）是一种已经经过验证的合适方法；然而，这种方法并非没有误差。在配方奶喂养的婴儿中，配方奶粉的稀释可能会产生误差。我们的目的是制定和验证评估配方奶喂养婴儿膳食摄入量的标准操作程序（SOP），并考虑潜在的误差来源。
我们分析了欧洲儿童肥胖症项目中 100 名婴儿的随机 3 天 FD 中潜在误差源的随机子样本。用于估计摄入量的计算方法是标准化的，并包含在一个软件工具（SOPsystem）中。由 9 名经过培训的营养师和 23 名营养学生（分别评估了 225 个和 575 个奶瓶）对模拟 FD 进行了评估，以比较使用和不使用 SOPsystem 时获得的结果。分析了模拟 FD 的正确答案（%）、变异系数和评估时间（分钟）。
总体而言，60%的 FD 报告了不正确的体积，37%报告了不正确的配方稀释。当使用 SOPsystem 时，模拟 FD 中的正确答案更频繁（P<0.001），平均变异系数和评估时间较低（P<0.005 和 P<0.01，分别）。
制定和实施具有软件工具的 SOP，可识别记录保存中特定的误差源，实现了评估配方奶喂养婴儿膳食摄入量的协调和改进流程，最大限度地减少了计算误差，并减少了投入的工作时间。
